黄体酮注射液与阴道缓释凝胶对实施体外受精与胚胎移植技术孕妇妊娠结局的影响比较:Meta分析

Virginal Progesterone Gel Compared with Subcutaneous Progesterone Injection in IVF-EM Cycles:A Meta-Analysis

目的比较黄体酮2种剂型(阴道缓释凝胶与注射液)对实施基于非冻融胚胎的体外受精与胚胎移植技术(IVF-ET)孕妇的妊娠结局的影响。方法计算机检索Cochrane Library、Embase、PubMed、Elsevier、ResearchGate、万方医学数据库、中国知网数据库、维普全文数据库,搜集关于黄体酮阴道缓释凝胶与黄体酮注射液影响IVF-ET结局的随机对照试验研究。采用Revman5.3版软件对数据进行Meta分析。结果共纳入10项研究。所有纳入研究的患者分为阴道缓释凝胶组和肌内注射组。Meta分析结果显示,2组的临床妊娠率(RR=0.98,95%CI:0.90~1.07)、继续妊娠率(RR=0.96,95%CI:0.79~1.17)、流产率(RR=0.80,95%CI:0.59~1.10)、活产率(RR=1.13,95%CI:0.97~1.31)无统计学差别。结论黄体酮阴道缓释凝胶和肌内注射液对采用IVF-ET妊娠结局相同。

Objective To compare the overall efficacy of virginal progesterone gel and subcutaneous progesterone injection for luteal phase support（LPS）after in vitro fertilization-embryo transfer（IVF-ET）.Methods This paper involved ten randomized controltrials from Cochrane Library,Embase,PubMed,Elsevier,ResearchGate,CNKI and Wanfang data.A meta-analysis was performed with Revman5.3 to analyze clinical pregnancy,ongoing pregnancy,abortion and live birth extracted from ten studies from January 1990 to June 2016.Results The meta analysis showed that the uses of virginal progesterone gel and subcutaneous progesterone injection for luteal phase support were similar in clinical pregnancy rates（RR=0.98,95%CI=0.90～1.07）,ongoing pregnancy rates（RR=0.96,95%CI=0.79～1.17）,abortion rates（RR=0.80,95%CI=0.59～1.10）and live birth rates（RR=1.13,95%CI=0.97～1.31）.There was no statistical significance.Conclusion This study demonstrated that virginal progesterone gel is comparable to subcutaneous progesterone injection for IVF-EM ART.